Diastasis is not such a dirty word
by Samah Elomari ( women's health physiotherapist)
The belly separation dilemma
So you’ve just given birth, and one of the midwives or in house hospital physios comes in to assess you for ‘abdominal separation’. That’s already got you a little worried. Then, you’re told you have a ‘significant’ abdominal separation. There’s a panic that sets in…it really is scary to hear. But you’ve got so many other things to worry about, and YOU aren’t at the top of your own list of priorities.
The physiotherapist tells you to do this exercise which involves drawing your tummy in about 50 times all day, every day. You may even get a handout telling you not to pick up heavy loads (uh…hello, I’ve just given birth to a 3+ kilogram baby), to change the way sit and stand, the way you get out of bed and even how you do your housecleaning. She’s lost you at ‘exercise’, and she knows it.
The belly separation solution
Don't panic! Abdominal separation is normal and there is easier, more effective and efficient ways of getting the results you want. Although you may have a separation, measured by fingers wide, it is actually the gentle tension that you can generate across this gap that will help healing of these tissues and encourage
- Great postural awareness is the best way to be always working on your belly healing. Sitting all slumped over, hips pushed forward when you stand or even butt tucking in standing all discourage the gentle abdominal activity that correct posture would other wise promote. Simply think of taller waists, a un-tucked butt and stacked ribs, feeling the gentle tension running across your belly that these simple strategies bring. It is as if you have 'zipped up' your mid-line zipper! Think of this as you sit to feed, or as you settle your babe in arms, or carrier them in your carrier out front.
- Breathing well and pelvic floor activation will also help. To breathe deeply, you will get your ribs moving and abdominal muscles contracting and relaxing as they do with natural breath. Spend a minute or 2 in your good posture when feeding or standing, and focus on mindful deep wide breaths.
- You can do small abdominal crunches to assist with belly mid-line healing also, with an excellent research paper from 2015* to support this claim. Ab crunches always face a bad rap when it comes to post natal rehab, however, done correctly, they can actually improve the abdominal narrowing significantly according to the significant results in this study. A visit to your wonderful women's health and pregnancy physio to teach you here would be highly recommended, as the ab crunch can be performed optimally and safely with great awareness or breath, pelvic floor and deep abdominal 'corset' too. Yes! All at once!
If you think you have an abdominal separation or have been told so, please don’t hesitate to give us a call. There’s a lot that can be said on this topic, and it can often be scary when reading all the mother's online forums or Dr Google. Physios are here for you.
This is part 2 of a two-part series. ‘Abdominal separation: what’s normal during pregnancy?’ to read part one.
- *Mota P, Pascoal AG, Carita AI, Bø K. The Immediate Effects on Inter-rectus Distance of Abdominal Crunch and Drawing-in Exercises During Pregnancy and the Postpartum Period. J Orthop Sports Phys Ther. 2015;45(10):781-788. doi:10.2519/jospt.2015.5459
